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The prevalence of online child pornography is a major societal issue. The criminal justice system has struggled with assessing the risk of individuals involved in online sexual offenses against children, especially when it involves the possession of child pornography. Research suggests there are different categories of offenders involved in this type of behavior (e.g., Online Child Pornography Offenders, Dual Offenders, Contact Offenders), with each category having different motivations, contributing factors, and levels of risk to re-offend or escalate their criminal behavior to more serious offenses (i.e., collecting pictures to contact offending). Determining the risk that individuals involved in online sexual offenses against children pose to re-offend or escalate their criminal behavior has been problematic. Traditional sexual offender risk measures have lower predictive validity when dealing with online child pornography offenders. This article discusses the need for a formalized hybrid risk assessment model that combines the current online sex offenses against children risk measures with digital forensics artifact analysis. The evidence derived from digital forensics artifact analysis can supplement the predictive risk factors obtained from these risk assessment tools, thus increasing the reliability and validity of the risk assessment.

Background: Standardized outcome reporting is crucial for trial evidence synthesis and translation of findings into clinical decision making. The OMERACT 2.0 Filter and COMET outcome domain taxonomy propose frameworks for consistent reporting of outcomes. There is an absence of a uniform dermatology-specific reporting strategy that uses precise and consistent outcome definitions. Objectives: Our aim was to map efficacy/effectiveness outcomes assessed in dermatological trials to the OMERACT 2.0 Filter as a starting point for developing an outcome taxonomy in dermatology. Methods: We critically appraised 10 Cochrane Skin Reviews randomly selected from all 69 Cochrane Skin Reviews published until 01/2015 and the 220 trials included covering a broad spectrum of dermatological conditions and interventions. Efficacy/effectiveness outcomes were mapped to core areas and domains according to the OMERACT 2.0 Filter. The extracted trial outcomes were used for critical appraisal of outcome reporting in dermatology trials and for the preliminary development of a dermatology-specific outcome taxonomy. Results: The allocation of 1,086 extracted efficacy/effectiveness outcomes to the OMERACT 2.0 Filter resulted in a hierarchically structured dermatology-specific outcome classification. In 506 outcomes (47%) the outcome concept to be measured was insufficiently described, hindering meaningful evidence synthesis. Although the core areas assessed in different dermatology trials of the same condition overlap considerably, quantitative evidence synthesis usually failed due to imprecise outcome definitions, non-comparable outcome measurement instruments, metrics and reporting. Conclusions: We present an efficacy/effectiveness outcome classification as a starting point for a dermatology-specific taxonomy to provide trialists and reviewers with the opportunity to better synthesize and compare evidence.

Atopic eczema (herein referred to as ‘eczema’) is a skin disease characterized by remitting and relapsing symptoms. The Harmonising Outcome Measures for Eczema (HOME) initiative was developed to establish a core outcome set (COS) for eczema to be measured for all future eczema trials. The core outcome set for atopic eczema clinical trials includes the domain for patient-reported eczema control, but a review of the validation of available eczema control instruments was lacking. We aimed to review the literature and systematically assess the measurement properties of validated patient-reported outcome instruments that capture eczema control. PubMed and Ovid EMBASE were searched up to 24 January 2020 for any study that reported on PROM instrument development or validation. The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria were used to assess the quality of eligible studies. We screened 12 036 titles and abstracts and 58 full texts. A total of 12 papers were included, reporting on seven PROMS. These were assessed with respect to development, reliability, construct validity and responsiveness. Two instruments, Recap of Atopic Eczema (RECAP) and the Atopic Dermatitis Control Tool (ADCT), have been developed and validated to a sufficient standard to support their recommendation as patient-reported outcome instruments for measuring control of atopic eczema as part of the HOME Core Outcome Set.

During the UK's COVID-19 pandemic lockdown there was national guidance to suspend routine dermatology work. As a consequence, over 800 patient appointments in a district general dermatology department were temporarily suspended. Remote consultations were carried out to triage and manage referrals, via telephone or video consultations. Data were prospectively recorded on 488 patient interactions. Outcomes included advice/treatment, discharge, surgery or clinic review; 25% of patients were either uncontactable or their problem had resolved. Over a third of referrals were discharged with advice/treatment initiated remotely; 56% of referred dermatoses required further clinical review; 25% of lesion referrals were booked directly to surgery. This process was time-intensive for the clinicians involved, and triage mechanisms could be improved. Sufficient referral information allows remote diagnosis; implementation of management plans and appropriate discharge of patients. This process has been shown to be feasible, and may be a temporary solution for other COVID-19 impacted dermatology departments.

BACKGROUND Human milk feeding is encouraged for all infants; however, the mammary gland depends on maternal dietary intake of vitamins A, B1, B2, B6, B12, D, docosahexaenoic acid (DHA), choline, and iodine. Nutrition support team knowledge of maternal feeding guidelines for these nutrient sources can therefore impact infant intake. We hypothesized that these key nutrients for lactation in the mother's diet would be less than the dietary guidelines in the United States. METHODS This was a secondary analysis of nutrition data collected during a randomized, controlled trial. Dietary records were analyzed from 16 mothers (13 with singleton and 3 with multiple births) completing the study. Mean dietary intakes of selected nutrients were calculated and compared with the current dietary reference intakes. RESULTS Mean maternal dietary intake for singletons was significantly (P < .05) lower than the dietary reference intakes for (vitamin A (58%), vitamin D (44%), and choline (58%);) DHA comprised only 5% of the current expert recommendation. Based on singleton recommendations, mothers to twins consumed an adequate intake except for DHA. CONCLUSIONS Women providing breast milk for singleton preterm infants did not consume dietary reference intakes for key nutrients. Twin mothers' diets were adequate except for DHA, but these guidelines are based on singleton pregnancies and remain poorly understood for twin needs. The nutrition support team can have a unique role in maternal dietary education to impact human milk nutrient delivery to the infant.

This paper considers the analysis of a repeat event outcome in clinical trials of chronic diseases in the context of dependent censoring (e.g. mortality). It has particular application in the context of recurrent heart failure hospitalisations in trials of heart failure. Semi‐parametric joint frailty models (JFMs) simultaneously analyse recurrent heart failure hospitalisations and time to cardiovascular death, estimating distinct hazard ratios whilst individual‐specific latent variables induce associations between the two processes. A simulation study was carried out to assess the suitability of the JFM versus marginal analyses of recurrent events and cardiovascular death using standard methods. Hazard ratios were consistently overestimated when marginal models were used, whilst the JFM produced good, well‐estimated results. An application to the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity programme was considered. The JFM gave unbiased estimates of treatment effects in the presence of dependent censoring. We advocate the use of the JFM for future trials that consider recurrent events as the primary outcome. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Estimating forage availability is important in optimizing livestock stocking rates. The rising plate meter was developed to estimate forage availability. It needs a calibration equation to convert its measurement to a prediction of forage mass, and predictions can vary across crops, seasons, and locations. Our research objective was to derive new calibration equations for wheat ( L.) and rye ( L.). Most past literature used a linear model, but recent literature has suggested that using a quadratic model without an intercept could improve predictions. A non-nested test was used to test among these two non-nested models for wheat and rye calibration equations. The results favored the more encompassing model of a quadratic with an intercept; however, with wheat the quadratic with no intercept was not rejected. A pooling test indicated different equations were needed for species, seasonality (winter and non-winter), and tillage type (tilled or no-till).

The Periodic Mobile Forensics (PMF) system investigates user behavior on mobile devices. It applies forensic techniques to an enterprise mobile infrastructure, utilizing an on-device agent named TractorBeam. The agent collects changed storage locations for later acquisition, reconstruction, and analysis. TractorBeam provides its data to an enterprise infrastructure that consists of a cloud-based queuing service, relational database, and analytical framework for running forensic processes. During a 3-month experiment with Purdue University, TractorBeam was utilized in a simulated operational setting across 34 users to evaluate techniques to identify masquerading users (i.e., users other than the intended device user). The research team surmises that all masqueraders are undesirable to an enterprise, even when a masquerader lacks malicious intent. The PMF system reconstructed 821 forensic images, extracted one million audit events, and accurately detected masqueraders. Evaluation revealed that developed methods reduced storage requirements 50-fold. This paper describes the PMF architecture, performance of TractorBeam throughout the protocol, and results of the masquerading user analysis.

Aim Pulmonary hypertension (PH) develops in 25–40% of bronchopulmonary dysplasia (BPD) patients, substantially increasing mortality. We have previously found that asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide (NO) production, is elevated in patients with BPD-associated PH. ADMA is metabolised by Nᴳ,Nᴳ-dimethylarginine dimethylaminohydrolase (DDAH). Presently, we test the hypothesis that there are single nucleotide polymorphisms (SNPs) in DDAH1 and/or DDAH2 associated with the development of PH in BPD patients. Methods BPD patients were enrolled (n = 98) at Nationwide Children's Hospital. Clinical characteristics and 36 SNPs in DDAH1 and DDAH2 were compared between BPD-associated PH patients (cases) and BPD-alone patients (controls). Results In BPD patients, 25 (26%) had echocardiographic evidence of PH (cases). In this cohort, DDAH1 wild-type rs480414 was 92% sensitive and 53% specific for PH in BPD, and the DDAH1 SNP rs480414 decreased the risk of PH in an additive model of inheritance (OR = 0.39; 95% CI [0.18–0.88], p = 0.01). Conclusion The rs480414 SNP in DDAH1 may be protective against the development of PH in patients with BPD. Furthermore, the DDAH1 rs480414 may be a useful biomarker in developing predictive models for PH in patients with BPD.

The hydrodeoxygenation of guaiacol is investigated over bulk ceria and ceria-zirconia catalysts with different elemental compositions. The reactions are performed in a flow reactor at 1 atm and 275-400 °C. The primary products are phenol and catechol, whereas cresol and benzene are formed as secondary products. No products with hydrogenated rings are formed. The highest conversion of guaiacol is achieved over a catalyst containing 60 mol % CeO2 and 40 mol % ZrO2 . Pseudo-first-order activation energies of 97-114 kJ mol(-1) are observed over the mixed metal oxide catalysts. None of the catalysts show significant deactivation during 72 h on stream. The important physicochemical properties of the catalysts are characterized by X-ray diffraction (XRD), temperature-programmed reduction, titration of oxygen vacancies, and temperature-programmed desorption of ammonia. On the basis of these experimental results, the reasons for the observed reactivity trends are identified.

Stockpiled forage for grazing during fall and winter can reduce winter feed costs for livestock producers. Tall fescue is used successfully as stockpiled forage in areas of the Midwest and Southeast. In the Southern Great Plains, drought conditions limit production, resulting in summer-active variety stand failure and summer-dormant variety persistence. This study compared the stockpiled production and nutritive value of summer-dormant type to summer-active type tall fescue [Lolium arundinaceum (Schreb.) Darbysh.]. The yield and nutritive value of stockpiled summerdormant tall fescue were similar to that of summer-active tall fescue. At the end of the study, severe drought occurred in the area, resulting in summer-active failure but summer-dormant persistence. BACKGROUND

AIMS: Heart failure is characterized by recurrent hospitalizations, but often only the first event is considered in clinical trial reports. In chronic diseases, such as heart failure, analysing all events gives a more complete picture of treatment benefit. We describe methods of analysing repeat hospitalizations, and illustrate their value in one major trial. METHODS AND RESULTS: The Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM)-Preserved study compared candesartan with placebo in 3023 patients with heart failure and preserved systolic function. The heart failure hospitalization rates were 12.5 and 8.9 per 100 patient-years in the placebo and candesartan groups, respectively. The repeat hospitalizations were analysed using the Andersen-Gill, Poisson, and negative binomial methods. Death was incorporated into analyses by treating it as an additional event. The win ratio method and a method that jointly models hospitalizations and mortality were also considered. Using repeat events gave larger treatment benefits than time to first event analysis. The negative binomial method for the composite of recurrent heart failure hospitalizations and cardiovascular death gave a rate ratio of 0.75 [95% confidence interval (CI) 0.62-0.91, P = 0.003], whereas the hazard ratio for time to first heart failure hospitalization or cardiovascular death was 0.86 (95% CI 0.74-1.00, P = 0.050). CONCLUSIONS: In patients with preserved EF, candesartan reduces the rate of admissions for worsening heart failure, to a greater extent than apparent from analysing only first hospitalizations. Recurrent events should be routinely incorporated into the analysis of future clinical trials in heart failure.

Grazing warm-season grass pastures with stocker cattle ( Bos taurus ) is an important eco-nomic activity in the southern Great Plains, and substantial increases in the price of N fertilizer have negatively affected profi tability of forage pro-ducers. The goal of the study was to determine if bermudagrass [ Cynodon dactylon (L.) Pers.] pas-tures interseeded with either annual or perennial legumes are more profi table than the conventional method of fertilizing with 112 kg N ha –1 commercial fertilizer. A completely randomized design grazing study was conducted in south-central Oklahoma during the spring and summer months of 2008, 2009, and 2010. Preconditioned stocker cattle (260 ± 47 kg head –1 ) were randomly assigned to pastures (1.42 ± 0.10 ha; three replicates per system) at 2.32 ± 0.40 animals ha –1 , begin-ning when measured standing forage reached 2000 kg ha –1 and grazing continuously until forage mass declined to 1000 kg ha –1 . Results of the 3-yr grazing study show that under continuous stock-ing for the growing conditions common to the south-central Great Plains, the legume systems could not compete economically with the com-mon practice of fertilizing bermudagrass pastures with synthetic inorganic N fertilizer. Results are most sensitive to number of grazing days, price of N, and prices of legume seed.J.T. Biermacher, R. Reuter, M.K. Kering, J.K. Rogers, J. Blanton, Jr., and T.J. Butler, The Samuel Roberts Noble Foundation, Inc., Ardmore, OK 73401; J.A. Guretzky, Dep. of Horticulture and Agronomy, Univ. of Nebraska, Lincoln, NE 68583-0915. Received 25 Aug. 2011. *Corresponding author (jtbiermacher@noble.org).

Aim: To test the hypothesis that plasma lipid metabolite levels in premature infants are associated with the development of bronchopulmonary dysplasia (BPD). The studies also tested a secondary hypothesis that plasma lipid metabolite levels were correlated with gestational age. Methods: Infants born

Continuous-flow centrifugation is widely utilized as the primary clarification step in the recovery of biopharmaceuticals from cell culture. However, it is a challenging operation to develop and characterize due to the lack of easy to use, small-scale, systems that can be used to model industrial processes. As a result, pilot-scale continuous centrifugation is typically employed to model large-scale systems requiring a significant amount of resources. In an effort to reduce resource requirements and create a system which is easy to construct and utilize, a capillary shear device, capable of producing energy dissipation rates equivalent to those present in the feed zones of industrial disk stack centrifuges, was developed and evaluated. When coupled to a bench-top, batch centrifuge, the capillary device reduced centrate turbidity prediction error from 37% to 4% compared to using a bench-top centrifuge alone. Laboratory-scale parameters that are analogous to those routinely varied during industrial-scale continuous centrifugation were identified and evaluated for their utility in emulating disk stack centrifuge performance. The resulting relationships enable bench-scale process modeling of continuous disk stack centrifuges using an easily constructed, scalable, capillary shear device coupled to a typical bench-top centrifuge.

The goal of this study was to examine the oral health status and utilization of dental care reported by hospitalized children. A bedside oral examination was performed on hospitalized children. Past dental treatment and current oral health needs were assessed. The mean age (+/- SD) of 120 enrolled patients was 6.7 (+/- 2.9) years (range 3 to 12); 60% were males. The age of the patients' first dental office visit was 3.5 +/- 1.8 years, with 28% having never seen a dentist. Unmet oral health needs (e.g., untreated dental caries) were noted in 42% of children, and soft tissue (mucosal) abnormalities in 59% of children. Children with chronic medical conditions reported barriers to receiving dental care more often (24%) than children with acute medical conditions (3.5%) (p=0.04). A high prevalance of unmet oral health needs and soft tissue abnormalities was identified in a hospitalized pediatric population. Children with chronic medical conditions were more likely to experience barriers to obtaining dental care.

Docosahexaenoic acid (DHA) is a long chain, fatty acid important for neurological development and the preterm infant misses the accretion of DHA that normally occurs in the last trimester of pregna...

Summary Reasons for performing study: Exercise-induced pulmonary haemorrhage (EIPH) and tricuspid (TR) and mitral valve regurgitation (MR) are conditions with high prevalence in conditioned Thoroughbreds. Stress failure of pulmonary capillaries, leading to EIPH, is most likely when pulmonary vascular pressure is increased, and mitral regurgitation can result in pulmonary venous hypertension. Hypothesis: There might be an association between MR and EIPH and the right ventricle (RV) of horses known to suffer repeated episodes of EIPH, as their hearts would be subject to higher pulmonary vascular pressures and cardiac output during training and hence increased RV afterload and preload. Methods: An echocardiographic and auscultation study was conducted in 121 race-fit National Hunt Thoroughbreds. Cardiac auscultation and echocardiography were performed. A guided M-mode image of the RV just below the tricuspid valve was obtained from a right parasternal location and colour flow Doppler (CFD) used to interrogate the tricuspid valve and right atrium. The mitral valve was similarly examined from the left hemithorax. Severity of TR and MR by CFD was graded. Binary data on EIPH, based on whether the horse was perceived to have a clinically significant problem with EIPH, were determined retrospectively for each horse by the horses' primary care veterinary surgeon from medical and other records. Data were analysed using a standard logistic regression analysis approach. Results: EIPH was significantly and positively associated with the systolic and diastolic dimensions of the RV (P=0.017 and 0.011 respectively) and this association was not sensitive to the effects of age or weight. There were no significant associations between EIPH and TR or MR by auscultation or CFD (TR: auscultation P=0.1; CFD P=0.2 and MR: auscultation P=0.07; CFD P = 0.37). Conclusions and clinical relevance: This study was limited by the method used to classify EIPH, but there was no association between EIPH and horse age, weight, TR or MR in this population of Thoroughbreds. Nevertheless, RV internal dimension was greater in horses obviously affected by EIPH, suggesting that factors resulting in EIPH may directly or indirectly affect RV remodelling in athletic horses.

The paraventricular nucleus (PVN) of the hypothalamus plays a key role in the control of appetite and energy balance. Both ghrelin and cannabinoid receptor agonists increase food intake when administered into this nucleus: this study investigated possible interactions between the two systems in relation to eating. The orexigenic effect of ghrelin (100 pmol) when infused in to the PVN was reversed by a small, systemic dose of the CB1 cannabinoid receptor antagonist SR141716 (1 mg kg−1). This is the first demonstration of a functional relationship between brain ghrelin and endocannabinoid systems, and, although it needs to be further investigated, the effect of ghrelin on food intake when injected into the PVN seems to be mediated by stimulation of cannabinoid release.

Background High-grade anal intraepithelial neoplasia (AIN III) may he premalignant. Surgical excision of large areas of anal epithelium carries significant morbidity. Ablation treatments may carry less morbidity; however, the depth of ablation is uncertain and failure to ablate dysplasia in hair shafts and other skin appendages may lead to early recurrence. Methods This study assesses morphometric aspects of skin appendages in perianal skin and anal canal mucosa in tissues from 30 patients with AIN Ill. Both normal and dysplastic epithelium was assessed in each patient. The depth to which AIN III involved skin appendages was measured using computerized image analysis. Results Both the perianal epidermis and anal canal mucosa affected by AIN 111 were significantly thicker than normal. Nineteen of 30 patients with AIN III had skin appendage involvement. Some 57 per cent of hair follicles (79 of 138), 16 per cent of sebaceous glands ( I of 69) and 25 per ccnt of sweat glands (24 of 96) observed beneath an abnormal epithelium had evidence of AIN. The median depth of AIN involvement of the hair follicle was 1.14 (range 1.44-167) mm, sebaceous glands 1.44 (range 0.96-190) mm, and sweat glands 11.94 (range 1.50-2.21) mm. These figures do not take into account tissue shrinkage due to histological processing. Conclusion AIN III involvement of epithelial appendages is a significant problem. For disease eradication, tissue destruction or removal to a depth of at least 2.2 mm below the adjacent basement membrane is requircd. Surgical excision of high-grade AIN remains the treatment of choice.

We have developed a numerical model to simulate the heat budget of a shallow ice-covered midlatitude lake. New features include: snowmelt due to rain, sediment heat transfer, formation of snow-ice, and variability in snow density, snow conductivity, and albedo. To test this model we conducted a field study of a shallow, midlatitude lake where there was no thermal stratification in winter beyond that associated with the ice and sediment interfases. The absence of stratification allowed us to focus our attention on the heat fluxes across these interfaces rather than the details of the thermal structure within the lake. Discrepancies between field observations and model predictions are accounted for by parameter uncertainties and expected observation error. Sediment heat transfer may be important in early winter in preventing a net loss of heat from the lake water. Significant heat gains in the latter part ofwinter, however, are attributed to the penetration of solar radiation through the ice. During the past few decades an increasing need to manage the quality of water in lakes and reservoirs has prompted the development of a large number of simulation models. The evolution of these models with advances in physical limnology and with increases in computing power is discussed by Tmberger and Patterson (1990). Even though many lakes fireeze for at least part of the year, few models allow for ice and snow cover. Fewer still establish a thermodynamic link with the underlying water column, thereby negating the need to specify the heat flux between the water and the ice as an external parameter. Of these, the model of Patterson and Hamblin (1988), called DYRESMI, provides perhaps the most accurate representation. It is based on the thermodynamic sea-ice model proposed by Maykut and Untersteiner (197 1) and divides the shortwave radiation into its visible and infrared components, assigning different attenuation coefficients for each component in both snow and ice. However, DYRESMI was developed for lakes at high latitude and does not account for some components of the heat budget that are often important in midlatitude lakes. We have developed a new model to address issues that may be of particular concern for midlatitude lakes. These

1. This study investigated the sources of sensory information upon which normal subjects' ability to stand depends. 2. An 'equivalent body' was used to simulate the physical properties of each subject's body during standing. The modulation of ankle torque required to support the equivalent body in an upright position was similar to that required to support the subject's own body when standing. However, when balancing the equivalent body, vestibular inputs were excluded from directing the appropriate changes in ankle torque. Thus, stability of stance could be studied with (normal stance) and without (balancing equivalent body) modulation by vestibular inputs. Vision could be excluded by closing the eyes. Sensory input from the feet and ankles could be removed by local anaesthesia from prolonged ischaemia, induced by occluding blood flow with inflated pneumatic cuffs just above the ankles. With vestibular, visual and peripheral sensory inputs negated, standing could rely only upon remaining sensory inputs, notably those from sensory receptors in the leg muscles. 3. Unlike the human body, the equivalent body used to negate vestibular inputs is not segmented. Therefore, the effects on stability of having a segmented body were determined by splinting subjects during standing so that only ankle movement was possible. This was done in the presence and absence of visual stabilization. 4. For each experimental task, either standing or balancing the equivalent body, sway was recorded while posture was unperturbed. Root mean square values of sway amplitude and power spectra were used to compare conditions. 5. Every subject could balance the equivalent body in a stable way when the eyes were closed, and when the feet were anaesthetized.(ABSTRACT TRUNCATED AT 250 WORDS)